Immigration Bill

Written evidence from Homeless Link (IB 48)

Summary

1. Homeless Link is the national membership charity for organisations working directly with homeless people in England. With over 500 members, we work to make services for homeless people better and campaign for policy change that will help end homelessness.

2. In this submission, we have focussed on Part III, Chapter I, ‘Residential tenancies’, and Part III, Chapter 2, ‘National Health Service’ of the Immigration Bill. We have a number of concerns about the restrictions contained within these parts to access to accommodation in the private rental market and to access to healthcare, and the potential impact that these will have on vulnerable people and people who are homeless.

3. As part of this summary, we would like to raise the following key points before the Committee which are then elaborated on elsewhere in the document:

· The restrictions to residential tenancies in the private rental sector (PRS) and the requirements to prove immigration status could push people who are legally entitled to live in the UK into homelessness. It could also limit access to an important source of stable accommodation for those who are already homeless.

· There are a number of particular challenges faced by people who are homeless regarding their access to documents which demonstrate their eligibility to rent in the PRS.

· There is a danger that landlords will discriminate against certain prospective tenants in order to minimise their own risk of renting a property to a person who is not eligible under the terms of this Bill.

· Requiring proof of eligibility for accessing NHS services and imposing charges on use will make it difficult for some people who are homeless to access health care. The burden on acute services will therefore be increased.

Access to private rented sector (PRS) accommodation:

1. We recognise and welcome the amendment which has been added to this Bill which is requiring that these changes are introduced on a pilot basis. However, we still have a number of concerns about the impact to vulnerable people and people who are homeless.

2. The PRS is an important source of stable and settled accommodation for people who are homeless or who are moving out of a hostel. There are already a number of challenges and barriers to accessing accommodation in the PRS for homeless people, for example difficulties in paying rent in advance, acquiring a deposit, or providing references; this Bill makes this access even more difficult.

3. For many people who are homeless and living in hostels, accessing documents which prove national or immigration status can be problematic. These people often live chaotic lives, move around frequently, and have no safe place to keep important documents such as a passport, or a birth certificate.

4. There is a real risk of discriminatory treatment towards individuals who are not easily identifiable as being legally resident in the UK. Landlords may make assumptions about nationality and eligibility based on the way someone looks or talks, and decide against tenancy agreements with certain groups.

5. There is a legal burden on landlords and their agents to carry out sufficient immigration checks to determine whether the tenant has long term residency status, and they face a fine of up to £3,000 where they have failed to do this. In many letting markets, demand for property is high; this means that landlords may find it preferable to rent to tenants where the legal risk is lower-i.e. where the tenant has a readily presentable UK passport. We know that some landlords already discriminate against certain groups because of a perceived level of risk; for example, only 2% of landlords are explicitly willing to let to people on benefits. [1] The checks required in this Bill will make such practices more likely.

6. This Bill makes renting from legitimate landlords in the PRS more difficult for people who are homeless and other groups, such as women who are escaping domestic violence. These vulnerable groups could instead be put in the position of renting from ‘rogue landlords’ which could result in them living in unstable, unsafe and unhealthy accommodation.

7. The documents required by landlords to determine eligibility should include evidence of being in receipt of benefits as standalone proof. People who have been homeless in the past may now be claiming benefits and their immigration status will already have been verified by the jobcentre or by DWP. Similarly, where housing benefits have been claimed for people staying in hostels, their immigration status will have already been confirmed, and therefore they should not be subject to additional checks when moving to the PRS.

8. We are concerned that the restrictions and requirements in this Bill will add to the cumulative impact of other reforms which are making properties in the PRS unobtainable for many tenants, such as: the extension of the shared accommodation rate to those aged 25-34; the reduction of Local Housing Allowance rates to the 30th percentile; the unaffordability of the new "affordable rent" regime; and uncertainty over the introduction of Universal Credit.

Access to Healthcare services

9. The health needs of the homeless population are considerable. Eight in ten homeless people have one or more physical health needs, and seven in ten have at least one mental health problem. [2] The estimated average age of death of a homeless person is 43-47 years of age. [3]

10. Despite this high need, we know that homeless people already face barriers to accessing primary health services, and are frequently being refused registration at GP practices. [4] A series of local audits across eleven local authority areas have found that 7% of homeless people have been refused registration to a GP or Dentist in the last year. [5] Other studies show that rough sleepers are significantly less likely to be registered with a GP: analysis from one Primary Care Trust shows that only 27% of rough sleepers were found to be registered. [6]

11. While we welcomed the recognition in the proposals from the Department for Health to protect the needs of vulnerable migrants and provide exemptions for some groups, the new systems brought in by this Bill and by the Department for Health’s proposals are still likely to exacerbate the barriers faced in accessing primary health care and restrict access to the vulnerably housed and other patient groups.

12. As has been outlined above, for many homeless people providing relevant documents to demonstrate their entitlement to free health care is difficult. Sourcing this proof can take time, and this can result in delays in seeking and accessing health care. During this time a person’s condition could worsen meaning the eventual cost to the NHS is increased.

13. Homeless people already rely heavily on acute health services: the Department for Health have estimated that homeless people use hospital services at a rate of 4 to 8 times greater than the general population [7] . The restrictions in this Bill make the reliance on acute services, with the costs burden this brings, even more likely.

14. We also have concerns about the impact these restrictions will have on the ability of outreach services to deliver health care to people who are on the street, or in drop-in facilities. These services are focused on reaching people with poor health and chaotic lives and these people are unlikely to possess formal documentation.

15. The Government has previously made commitments to addressing the barriers faced by homeless people and rough sleepers in accessing basic health care through the Ministerial Working Group on Homelessness’s Making Every Contact Count strategy. [8] However, with over half (53%) of rough sleepers in London being non-UK nationals (with this proportion being reflected across many other parts of the county) the impact of this Bill on rough sleepers’ access to health care will be considerable.

16. There should be an exemption from the requirement to provide proof of nationality or residency for rough sleepers. Whilst we recognise the difficulties of implementing this in practice, it will go some way in ensuring that the health needs of this population do not worsen.

Recommendations to the Committee

17. We call on the Committee to seek clarity from Government on how they will ensure that the provisions in this Bill do not lead to discriminatory behaviours which contravene equality law as set out in the Equalities Act (2010).

18. We recommend that the Committee reviews the list of documents which are considered acceptable as proof of eligibility to access services. In particular, evidence that a person is or has been claiming benefits should be permissible as standalone evidence of eligibility to rent in the PRS.

19. We call on the Committee to seek clarity from the Government around what exemptions will be put in place for vulnerable or disadvantaged patients accessing health services, including those who are homeless. The Committee should also seek details on how these exemptions will be put into practice. We urge the Committee to call for specific exemptions to be applied for rough sleepers.

20. Recognising that the health needs of the homeless population are significantly higher than those of the general population, we recommend that the Committee calls for a full assessment into how the proposals set out in this Bill will impact on this group.

November 2013


[1] ‘Nowhere to move,’ Homeless Link. (2013). Available at: http://homeless.org.uk/sites/default/files/attached-downloads/No%20Where%20To%20Move_FINAL.pdf

[2] ‘The health and wellbeing of people who are homeless,’ Homeless Link. (2010). Available at: http://homeless.org.uk/sites/default/files/Health%20Audit%20Findings_National%20evidence_0.pdf

[3] ‘Homelessness: a silent killer,’ Crisis. (2011). Available at: http://www.crisis.org.uk/data/files/publications/Homelessness%20-%20a%20silent%20killer.pdf

[4] ‘Sixth National Inclusion Health Board meeting notes,’ National Inclusion Health Board. (2013). Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/253745/2._20130604_-_Meeting_minutes.pdf

[5] ‘Tackling barriers to accessing health services: GP registration for vulnerable and transient groups,’ Homeless Link, 2013

[6] ‘Rough Sleepers: health and healthcare, A review of the health needs and healthcare costs of rough sleepers in the London boroughs of Hammersmith and Fulham, Kensington and Chelsea, and Westminster’, NHS North West London. (2013). Available at: http://homeless.org.uk/sites/default/files/Rough%20Sleepers%20Health%20and%20Healthcare%20Summary.pdf

[7] ‘Healthcare for single homeless people,’ Department for Health. (2010). Available at: http://www.dhcarenetworks.org.uk/_library/Resources/Housing/Support_materials/Other_reports_and_guidance/Healthcare_for_single_homeless_people.pdf

[8] ‘Making every contact count: a joint approach to preventing homelessness,’ Department for Communities and Local Government. (2012)https://www.gov.uk/government/publications/making-every-contact-count-a-joint-approach-to-preventing-homelessness

Prepared 21st November 2013